Do you often feel exhausted even when you haven’t done all that much? There’s a good chance you suffer from chronic fatigue syndrome (CFS), a complex multisystem disease characterised by overwhelming fatigue, cognitive dysfunction, and sleep problems that can affect your everyday life (read part one of this article here).

For most people, a diagnosis of CFS is lifelong, and the likelihood of making a return to your pre-illness level is less than 10%. That said, this does not mean nothing can be done about it.

Common approaches that can help with managing symptoms and improving quality of life include:

1. Rest and pacing

Pacing is a strategy that helps you function using your available energy. Pacing daily tasks and learning to balance activity with rest can help those affected by CFS to achieve stability and prevent further fatigue.

For starters, divide physical activity into smaller segments with sufficient intervals of rest in between. Keep a record of your activities in a diary, and track symptoms as you gradually increase or decrease your activity levels to determine what is sustainable.

Alternating between physical and cognitive activities can also help distribute the energy required. Pinpoint activities that drain your energy the most and schedule additional rest time before and after.

Importantly, refrain from engaging in too many energy-draining activities on the same day. Pay attention to the signals your body is giving you, to prevent severe episodes of exhaustion.

2. Exercising safely

While exercising does not address the root cause of CFS, when done safely, it can effectively enhance one’s functional strength and fitness levels.

The challenge, however, lies in the energy-limiting nature of CFS, which makes patients feel worse, not better, after physical activity. Hence, all exercise needs to be carefully thought out in advance.

Try different types of physical exercise to determine which suits you the best. Opt for low-impact gentle exercises such as yoga, stretching, seated tai chi, walking, and light weightlifting. Some people may find exercises that are done while lying down to be less taxing.

CFS patients often experience a temporary feeling of wellbeing immediately after exercising, followed by a crash later on. Therefore, it is important to keep track of how you feel for hours to days after exercising.

Ultimately, do not allow yourself to be coaxed into pushing past your physical or mental limits, as this is not only hazardous to your health but also often results in long-lasting setbacks.

3. Managing symptoms

Your doctor may rank your CFS according to four different severity levels:

• mild – 50% reduction in pre-illness activity;
• moderate – mostly housebound;
• severe – mostly bedridden;
• very severe – bedridden and need help with basic activities including nutrition and hydration.

Work with a trusted clinician to manage your symptoms, beginning with those that have the most detrimental effect on your quality of life. Good sleep hygiene – such as going to bed and waking up at regular times, limiting daytime naps, and avoiding stimulants such as caffeine, alcohol and nicotine – can also help.

If you have issues such as muscle or joint pain, your doctor will be able to prescribe suitable medications. Complementary therapies such as meditation, gentle massage, deep breathing, or relaxation therapy could be helpful, too.

None of these is a one-size-fits-all approach as every individual’s journey with CFS is unique. Thus, it is crucial not only to find a doctor with whom you can work closely to address all your needs, but who can also empathise with your emotional experiences.

This article was written by DOC2US, a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere.